Pregnancy is a joyous time for many women, which ends happily with a healthy baby, through only minor aches and pains (except labor! But we’ll get to that). Unfortunately, for some women, there are some complications that arise, warranting a bit of extra attention and difficulty (but which still usually ends with a healthy baby). What are these complications? What are the signs and symptoms? And what do you do about them?
First, it’s important to understand that while many complications warrant some extra attention from your doctor (and switching to a doctor if you weren’t already seeing one), they aren’t extremely serious nor immediately threatening to you or your baby. A complication is simply something unexpected that arises during pregnancy that may or may not eventually cause harm. And even in cases where harm could occur, most doctors are on top of your symptoms and are ready to intervene before that happens. Having complications does not mean there will be a poor outcome!
Being aware of potential symptoms and always doing basic testing is important, because it will help your doctor or midwife to know before problems occur if something might be going wrong.
What are Common Complications?
These are some of the most common complications of pregnancy (in no particular order):
- High blood pressure
- Gestational diabetes
- PUPPS (an itchy rash on your belly)
- Ectopic pregnancy (very early on)
- Pre-term labor (this can happen for a variety of reasons)
- Placenta previa
- Group B strep (is a “problem” only in labor, but we’ll talk about it later)
- Cervical insufficiency (one reason for pre-term labor, usually very early; 15 – 18 weeks)
There are other complications, but there are the ones you’re most likely to encounter. High blood pressure and gestational diabetes can occur at any time. PUPPS, preeclampsia, cholestasis, pre-term labor, placenta previa, and group B strep typically occur towards the end. Ectopic pregnancy is early on, and cervical insufficiency is mid-way through. There are steps you can take towards preventing all of these; eating a healthy pregnancy diet is one way! If you are malnourished, your chances of experiencing complications are greatly increased. Minimizing stress can help too.
What are the Symptoms?
Symptoms will vary depending on what you have. In general, you are looking for:
- High blood pressure
- Sugar/protein in urine
- Cramping/contractions that are regular or worrisome (happen often, even if not regular)
- Itching that is extreme
- Rapid or unusual weight gain
These symptoms will tell your care provider that something may be going on and that further testing is warranted. Your provider will determine which complication is most likely.
So Now What?
The treatment for many of these includes extra rest, up to and including complete bedrest (maybe at home; maybe in-hospital, depending on the particular complication). The first step is usually “get more rest.” If you’re working, or have other children, you may simply laugh at this request! But it’s worth it, for your health and your baby’s, if you can spend more time sitting down with your feet up. Have older children help (my 3-year-old can be a big help now if she wants to) or ask friends or family to come and help sometimes. Definitely, ask your spouse to do more on the evenings and weekends. Sometimes, rest is all that is needed to hold off further complications; so it’s worth it to try!
Bedrest is another matter entirely, and one we’ll be talking about next week.
Following a special diet may be recommended as well. Those with gestational diabetes, kidney stones, or other issues may require certain types of diets. (FYI, kidney stones are usually caused by years of eating poor-quality food and not enough fat. Consuming adequate amounts of healthy fats and also drinking lemon juice and baking soda in water can help to remedy this, but I would wait until after pregnancy to do anything radical.) There’s a debate about whether those with diabetes ought to follow a high-carb or low-carb diet. Knowing what high-carb does to my blood sugar (and I’m not diabetic), I’d go with low-carb. Avoiding sugar is key, but that’s really true for anyone. Speak to your health provider about your specific requirements.
For cervical insufficiency, your doctor can do what is called a “cerclage,” or actually stitching your cervix shut until around 36 – 37 weeks (this is unfortunately usually a treatment used in a second pregnancy because most insufficiencies aren’t discovered until after a late miscarriage).
PUPPS is very uncomfortable but not dangerous, so there’s not much you can do.
Preeclampsia can become serious, and very quickly, so it’s important to constantly monitor weight gain, swelling, and blood pressure. If anything increases suddenly, get to your doctor immediately. If your condition worsens, your doctor will put you in the hospital and make a decision about whether or not to induce your labor or schedule an emergency c-section. With minor signs, your condition can be managed from home, but expect to see your doctor at least weekly plus check weight, edema, and blood pressure daily from home.
Group B strep…we’ll be talking about this later, but I do not believe it is the “terrible” thing they make it out to be. The truth is, maybe 1 in 10,000 babies are going to suffer permanent complications or death from this (or less…I did the math once and it may have been as few as 1 in 24,000). Far more will be hurt by the preemptive antibiotics in labor. Antibiotics, in general, are way, way overused and should never, in my opinion, be used preemptively. They should be reserved for cases where an infection is clearly present and is a danger to the person’s health only. That’s just my two cents on that one.
Do I Need a Special Doctor?
For common complications, no. You won’t. You’ll still see your normal doctor, though you may see him more often. Most of these are relatively minor as long as they’re managed (like gestational diabetes) and they’ll go away once the baby arrives. As long as you are careful and are aware of any unusual symptoms, there is no reason why you can’t have a basically normal, healthy pregnancy.
If your condition progresses or cannot be managed, you may need to see a special doctor to find out why.
Have you ever experienced a complication in pregnancy? What happened?